摘要
目的:探讨心率减速力(DC)在预测表阿霉素对恶性肿瘤患者心脏毒性中的价值。方法:回顾性分析广西医科大学附属肿瘤医院经病理确诊为恶性肿瘤并用含表阿霉素方案化疗的140例患者临床资料,收集所有患者化疗前后CK-MB、cTn I、动态心电图资料,根据计算出的DC值分为DC>4.5 ms组和DC≤4.5 ms组,对比两组含表阿霉素方案患者化疗前、化疗2、4个周期后CK-MB、cTn I水平及动态心电图平均心率、室上性及室性心律失常计数。结果:两组患者化疗前相关临床病理资料比较,差异无统计学意义(P>0.05);化疗4个周期后DC≤4.5 ms组的血清CK-MB和cTnⅠ浓度与化疗前差值的均数高于DC>4.5 ms组,差异有统计学意义(P<0.05);化疗2、4个周期后DC≤4.5 ms组的平均心率、室上性心律失常及室性心律失常计数与化疗前差值的均数高于DC>4.5 ms组,差异均有统计学意义(P<0.05);化疗后DC≤4.5 ms组中23例患者c TnⅠ异常升高,且cTnⅠ升高患者与c TnⅠ正常患者在化疗前CK-MB和c TnⅠ浓度、平均心率、室上性心律失常及室性心律失常比较,差异无统计学意义,而c TnⅠ升高患者的DC值明显低于cTnⅠ正常患者,差异有统计学意义(P<0.05)。结论:表阿霉素导致心脏毒性发生的风险随患者DC值下降而增加,化疗前检测DC值能较好地预测患者发生表阿霉素心脏毒性的风险。
Objective： To investigate the effectiveness of heart rate deceleration capacity（DC） measurement in predicting the cardiotoxicity of malignant tumor patients treated with epirubicin-based chemotherapy. Methods： The clinical medical records, including CK-MB and c Tn I levels and dynamic electrocardiogram（ECG） parameters before and after each chemotherapy cycle, of 140 patients treated with epirubicin-based chemotherapy were analyzed. Patients were divided into the DC〉4.5 ms group and the DC≤4.5 ms group based on the calculated DC values. The CK-MB and c Tn I levels and the dynamic ECG parameters of the two groups were compared after two and four cycles of chemotherapy. Results： Patients in the two groups exhibited no statistically significant difference in their relevant clinical and pathological data before receiving chemotherapy（P〉0.05）. However, after four cycles of chemotherapy, the DC≤4.5ms group showed a significantly greater increase in serum CK-MB and c Tn I concentrations over the pre-chemotherapy levels compared with the DC〉4.5 ms group. After two and four cycles of chemotherapy, the DC≤4.5 ms group also exhibited a significantly greater increase in mean heart rate（beats/min） and supraventricular and ventricular arrhythmia counts（times/24 h） over the pre- chemotherapy values compared with the DC〉4.5 ms group（P〈0.05）. After four cycles of chemotherapy, 23 cases showed abnormally elevated c Tn I levels in the DC≤4.5 ms group. In this group, patients with elevated c Tn I level exhibited no statistically significant difference in CKMB and cTn I concentrations, mean heart rates, and supraventricular and ventricular arrhythmia counts compared with those with normal cTn I level before chemotherapy（P〉0.05）. However, the DC values of patients with elevated c Tn I were significantly lower than those with normal cTn I level（P〈0.05）. Conclusion： The risk of epirubicin-induced cardiotoxicity increased with decrease in DC value.The DC test was shown to be an
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2015年第13期648-652,共5页
Chinese Journal of Clinical Oncology
基金
广西卫生与计划生育委员会自筹课题项目(编号:Z2015600)
广西医学高层次骨干人才培养“139”计划资助~~
关键词
心率减速力
表阿霉素
心脏毒性
预测价值
heart rate deceleration capacity
epirubicin
cardiotoxicity
predictive value
